Generalized Anxiety and Panic Disorder

Anxiety—formally ‘‘discovered’’ in 1844 by Sören Kierkegaard in the book titled Begrebet angest, translated into English in 1944 as The Concept of Dread—has undergone a series of changes in conceptions (McReynolds, 1985). Anxiety was thought to be a result of having the freedom to choose as well as having an apprehension associated with seeking the unknown (Goodwin, 1986; McReynolds 1985). Since then, the awareness of and knowledge about anxiety, including definition, symptoms, treatments, and etiology, have significantly increased. Concepts such as anxiety, apprehension, worry, nervousness, panic, fright, and fear have caused confusion and misunderstandings, and although some believe that these constructs interact with each other (Grey, 1991), others believe that these constructs are certainly separable (Craske, 1999; Perkins, Kemp, & Corr, 2007). Research has shown that there are basic emotions, those that are hardwired or innate, and emotions that are a product of cognitions and associations of the basic emotions (Craske, 1999). In a study conducted by Power and Tarsia (2007), results showed that five independent basic emotions that include sadness, anger, disgust, and happiness lead to more complex emotions such as irritation, annoyance, nostalgia, love, and anxiety. Precisely, fear was found to be the basic emotion of anxiety, nervousness, tension, and worry. Perkins and colleagues (2007) found that fear was not only distinguishable from anxiety, but also accounted for a significant amount of unique discrepancies in applied performance. Miceli and Castelfranchi (2005) stated that fear and anxiety are similar in that they both share concern for threat; however, anxiety involves an indefinite threat because there is no specific threat or cue producing the anxiety, whereas fear indicates a specific threat or injury. Craske (1999) classified fear as one of the basic emotions, a hardwired biological event, whereas anxiety characterizes those cognitive emotions that represent cognitive processes that are less imbedded biologically and vary depending on life experiences. Craske et al. (2009) defined anxiety as a future-oriented mood state that prepares the individual for an impending adverse event, whereas fear is an alarm response to a present or an apparent event. Considered a universal feeling, anxiety commonly suggests an experience of varying blends of uncertainties, agitation, and dread with the individual experiencing cardiovascular, gastrointestinal, muscular, and respiratory symptoms (Zal, 1990). Anxiety is a nervous and